Anorectal Malformation

  • Etiology: congenital, is high if rectal pouch is above levator sling, is low if rectal pouch is below levator sling
  • Imaging: high atresia – rectourethral fistula demonstrated by colostomy injection, enterolith – intraluminal meconium may calcify when mixed with urine from rectourethral fistula
  • Complications: rectoperinal fistula – 95% of anorectal malformation have recto-perineal fistula, in male 50% goes to urethra + 30% goes to seminal vesicle, in female 40% goes to urethra + 30% goes to vestibule + 25% goes to vagina, often have continence issues post op
  • Clinical: have VACTERL syndrome whose anomalies can involve the Vertebral bodies, Anal atresia, Cardiac, TracheoEsophageal fistula, Renal, and Limb (radial ray)

Cases of Anorectal Malformation

AXR of anorectal malformation
AXR shows a distal bowel obstruction with gas down to the rectum. On physical exam the anus was absent.